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Adverse Outcomes in Group Psychotherapy

Risk Factors, Prevention, and Research Directions

Received February 29, 2000; revised April 3, 2000; accepted April 4, 2000. From the Adult Division, Department of Psychiatry, Vanderbilt University, Nashville, Tennessee. Address correspondence to Dr. Roback, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN 37232.

Group forms of therapy have been growing at a rapid rate, in part because of their documented effectiveness and economic considerations such as managed care. It is therefore becoming increasingly important to assess the psychological risks of these interventions. The author provides an overview of the published literature and conference presentations on negative effects in adult outpatient groups. Although much of the literature on adverse outcomes in group therapy focuses on single risk factors (e.g., negative leader, group process, or patient characteristics), the author argues that an interactional model should be encouraged. Means of reducing casualties are also discussed, as well as methodological issues and research directions.

Key Words: Psychotherapy, Group